Provider Demographics
NPI:1730787532
Name:WARREN, ELIZABETH (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:WARREN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1274 STAR GRASS LN
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-6524
Mailing Address - Country:US
Mailing Address - Phone:260-246-2980
Mailing Address - Fax:
Practice Address - Street 1:1211 FARMINGTON LAKES DR
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-5109
Practice Address - Country:US
Practice Address - Phone:815-468-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-14
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst